England’s Chief Inspector of Hospitals told Tees, Esk and Wear Valleys NHS Foundation Trust that although the overall trust is doing well, it must make improvements to the safety of two core services after its latest inspection by the CQC.
The regulator visited in November 2016 to inspect acute wards for adults of working age and psychiatric intensive care units, and wards for older people with mental health problems.
CQC found there had been some improvements to wards for adults of working age and psychiatric intensive care units, and the service is rated as Good overall. CQC inspected seventeen wards as part of this inspection. The Peppermill unit within this service, which was previously run by Leeds and York Partnership from another location, has seen significant improvement whilst under the management of TEWV. However improvements are needed to this service overall as there are concerns around safety which is rated as Requires Improvement.
Three units, Worsley Court, Cherry Tree House, and Meadowfields, all based in Vale of York, were originally run by LYP and were rated as Inadequate. These three wards were transferred into the older people with mental health problems service at Tees, Esk and Wear Valleys in October 2015 and there was improvement under the trust’s management. Following this inspection of twelve wards, the rating for this service overall is Requires Improvement after inspectors found concerns around safety.
The trust remains rated as Good overall. The inspection reports including individual services can be found at: http://www.cqc.org.uk/provider/RX3.
Dr Paul Lelliott, the Deputy Chief Inspector of Hospitals (and CQC lead for mental health), said:
“This was a complex report as some wards within these services were previously rated Inadequate and being run by another trust."
“Tees, Esk, and Wear Valleys took over the running of some wards within the Vale of York, which now fall under their services; acute wards for adults of working age, and wards for older people with mental health problems."
"Although there has been improvement to the wards that the trust took on, CQC is still concerned by the overall safety of all wards within these two services and is disappointed by the limited progress that we asked them to make at our previous comprehensive inspection in January 2015, which did not include the wards taken on by the trust in the October of that year."
“We found additional serious concerns regarding the safety, cleanliness and privacy of some of the wards for older people and this service is rated as Requires Improvement overall."
“Although inspectors found some areas of good practice, it was clear that this was not consistent across the trust. Among other things, the trust must make improvements to the physical environment of some areas to ensure people’s privacy and dignity."
“Our inspectors will return to check on the progress of these improvements at a later date.”
Inspectors identified a number of areas where the trust must make improvements on the wards for older people with mental health problems including:
- The trust must ensure that staff complete mandatory training.
- The trust must ensure that they regularly review staffing levels to ensure the observation of patients takes place and that staffing levels meet with the level of patient need and complexity.
- The trust must ensure that the environment at Worsley Court is clean, safe and fit for purpose.
- The trust must ensure that clinic rooms are clean, tidy and allow staff quick access to equipment and medication that is stored correctly and safely.
- The trust must ensure that staff monitor and record physical observations following the administration of rapid tranquilisation in line with trust’s policy.
Inspectors identified a number of areas where the trust must make improvements on the acute wards for adults of working age and psychiatric intensive care units:
- The trust must ensure that each ward carries out a survey of their physical environment and reviews it yearly, in relation to suicide prevention. Staff must be aware of ligature risks and blind spots on the wards, and be able to identify how they might lessen these risks.
- The trust must ensure that all staff have completed their mandatory training in immediate life support as a minimum standard for staff that deliver, or are involved in the rapid tranquilisation, physical restraint, and seclusion of patients.
- The trust must ensure that staff recognise when patients are being secluded in rooms other than a seclusion room in line with their policy.
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For further information please contact CQC Regional Engagement Officer Kerri James by email kerri.james@cqc.org.uk or by phone on 07464 92 9966.
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